To the Editor,

I have been diagnosed with pelvic floor dysfunction, anismus, colon transit dysfunction, irritable bowel syndrome with constipation, excessive intestinal flatulence, and gastroparesis. The only treatment regimen that provides relief for me is enema administration using large-volume 4,000-cc tap water enemas and soap suds enemas. I have employed the services of an LPN to assist me in the enema administration. I have sought advice from gastroenterologists at Indiana University, Mayo Clinic, and Cleveland Clinic.

To date I have not received an answer to my most important question: What can I take to at least reduce the amount of pain and cramping that I experience during the administration of the large-volume enemas? It normally takes 45 minutes or more to administer the enema because the pain and cramping are so severe. My nurse has stated that in her 39 years of nursing practice, she has never treated a patient with such severe pain, cramping, and symptoms related to administration of large-volume enemas.

The pain and cramping begin immediately upon infusion of the enema solution. My gastroenterologist prescribed Robinul to reduce the pain and cramping, but the medication has been of no benefit and has not reduced the pain or cramping. I have conformed to all known and accepted standard protocols for proper administration of enemas (temperature, height of suspension of the enema bag, recommended colon tube insertion length, and use of hose clamp to control flow rate) with absolutely no improvement in reduction of the pain, cramping, and discomfort. I am hoping the nursing experience and knowledge of your readers may have included treating a patient with my symptoms, diagnoses, and complaints. If so, I would appreciate their responding to this correspondence with suggestions or recommendations that could help me.

Sincerely,

Jeffrey G. Fihn

[email protected]